Provider Demographics
NPI:1578014130
Name:HOME HEALTH AID
Entity Type:Organization
Organization Name:HOME HEALTH AID
Other - Org Name:HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:M
Authorized Official - Prefix:MR
Authorized Official - First Name:IZIMEKWA
Authorized Official - Middle Name:I
Authorized Official - Last Name:ONDEPE
Authorized Official - Suffix:III
Authorized Official - Credentials:M
Authorized Official - Phone:240-467-1546
Mailing Address - Street 1:5822 MENTANA ST
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3505
Mailing Address - Country:US
Mailing Address - Phone:240-467-1546
Mailing Address - Fax:
Practice Address - Street 1:5822 MENTANA ST
Practice Address - Street 2:5
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3505
Practice Address - Country:US
Practice Address - Phone:240-467-1546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12447146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty